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Local practice variations and payer differences underlie state-wide disparities in oncoplastic breast surgery.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2024 Aug; Vol. 130 (2), pp. 210-221. Date of Electronic Publication: 2024 Jun 28. - Publication Year :
- 2024
-
Abstract
- Background: Little is known about disparities in oncoplastic breast surgery delivery.<br />Methods: The Massachusetts All-Payer Claims Database was queried for patients who received lumpectomy for a diagnosis of breast cancer. Oncoplastic surgery was defined as adjacent tissue transfer, complex trunk repair, reduction mammoplasty, mastopexy, flap-based reconstruction, prosthesis insertion, or unspecified breast reconstruction after lumpectomy.<br />Results: We identified 18 748 patients who underwent lumpectomy between 2016 and 2020. Among those, 3140 patients underwent immediate oncoplastic surgery and 436 patients underwent delayed oncoplastic surgery. Eighty-one percent of patients who underwent oncoplastic surgery did so in the same county as they underwent a lumpectomy. However, the relative frequency of oncoplastic surgery varied significantly among counties. In multivariable regression, public insurance status (odds ratio: 0.87, 95% confidence interval: 0.80-0.95, p = 0.002) was associated with lower odds of undergoing oncoplastic surgery, even after adjusting for macromastia, other comorbidities, and county of lumpectomy. Average payments for lumpectomy with oncoplastic surgery were more than twice as high from private insurers ($840 vs. $1942, p < 0.001).<br />Conclusion: Disparities in the receipt of oncoplastic surgery were related to differences in local practice patterns and the type of insurance patients held. Expanding services across counties and considering billing reform may help reduce these disparities.<br /> (© 2024 Wiley Periodicals LLC.)
- Subjects :
- Humans
Female
Middle Aged
Massachusetts
United States
Aged
Adult
Insurance, Health
Practice Patterns, Physicians' statistics & numerical data
Practice Patterns, Physicians' economics
Follow-Up Studies
Prognosis
Breast Neoplasms surgery
Breast Neoplasms economics
Mastectomy, Segmental statistics & numerical data
Mastectomy, Segmental economics
Mammaplasty economics
Mammaplasty statistics & numerical data
Mammaplasty methods
Healthcare Disparities statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 130
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38941173
- Full Text :
- https://doi.org/10.1002/jso.27755